Hyperbilirubinemia and phototherapy in newborns: Effects on cardiac autonomic control

Uhrikova, Zuzana; Zibolen, Mirko; Javorka, K; Chladekova, Lenka; Javorka, Michal

doi:10.1016/j.earlhumdev.2015.03.009

Cited by 19 publications

(18 citation statements)

References 26 publications

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“…Recent studies revealed higher HRV associated with a tendency to increase within the first postnatal days in full-term neonates compared to preterm neonates [ 4 ]. In pathological conditions, reduced HRV is associated with hypoxic-ischemic encephalopathy [ 5 ], intraventricular hemorrhage [ 6 ], respiratory distress syndrome [ 7 ], persisting ductus arteriosus [ 8 ], infection and sepsis [ 9 ], hyperbilirubinemia requiring phototherapy treatment [ 10 ], etc. Therefore, HRV analysis has become a promising and sensitive tool in neonatal practice, which allows early detection of disease onset, even within several hours before its clinical manifestation [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Heart rate variability in healthy term newborns is related to delivery mode: a prospective observational study

Kozar

Tonhajzerová

Mestanik

et al. 2018

BMC Pregnancy Childbirth

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BackgroundEarly postnatal period is characterized by dramatic adaptation changes of cardiovascular and respiratory systems in newborns. There is still insufficient data regarding maturation of autonomic regulatory mechanisms in neonates early after delivery. Aim of this study was to analyze cardiac autonomic regulation in newborns within the first few postnatal days in relation to different modes of delivery using time and spectral heart rate variability analysis.MethodsEutrophic healthy term newborns (n = 46) were divided into three groups according to the delivery mode: vaginal delivery (VD group; n = 16), vaginal delivery with epidural analgesia (EDA group; n = 16), and caesarean section under general anesthesia (CS group; n = 14). Heart rate variability (HRV), blood pressure (BP), and blood oxygen saturation (SpO2) were measured within the first two hours after birth and on the third to fourth postnatal day. HRV parameters were evaluated in the time domain (RR intervals, mean square of successive differences – MSSD) and frequency domain (total spectral power – TP, absolute and relative low and high frequency powers).ResultsThe HRV spectral analysis showed significantly higher relative power of the high-frequency band (HF%) in the VD group compared to the CS group early after delivery (p = 0.002). HRV parameters and BP significantly increased on the third to fourth postnatal day in all groups (p < 0.05). No significant differences in basic characteristics, BP and SpO2 were identified between groups during both measurements.ConclusionsHRV analysis revealed higher cardiovagal modulation in spontaneously born newborns without analgesia compared to neonates born by caesarean section. It could represent a potential pathomechanism that leads to discrete abnormal neurocardiac regulation associated with higher risk for worsened postnatal adaptation of cardiovascular system in surgically delivered neonates.

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Section: Introductionmentioning

confidence: 99%

Heart rate variability in healthy term newborns is related to delivery mode: a prospective observational study

Kozar

Tonhajzerová

Mestanik

et al. 2018

BMC Pregnancy Childbirth

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“…However, there are very few studies about the UCH effects on the cardiovascular system. Several studies have been conducted on autonomic control and heart rate variability to demonstrate the relationship between the cardiovascular system and hyperbilirubinemia (5) . There are also two in vitro studies investigating the effects of hyperbilirubinemia on myocardial function (12,13) .…”

Section: Discussionmentioning

confidence: 99%

“…They reported a decrease in breathing rate and increased apnea frequency, and they detected that the inhibition of laryngeal and pulmonary chemoreflexes and bradycardia were more common in the preterm lambs with hyperbilirubinemia. Uhrikova et al (5) found that UCH caused heart rate variability by disrupting autonomic function. In another study performed with 50 cases with high bilirubin level (20.23±5.53 mg/dL) and 50 healthy newborns, Özdemir et al (8) found that the mean minimum heart rate, rMSDD, LF, and LF/HF ratio in the study group were significantly lower due to autonomic dysfunction caused by parasympathetic dominance.…”

Section: Discussionmentioning

confidence: 99%

“…However, a great number of these studies have mainly focused on the neurotoxicity of the oxidative stress induced by high UCH levels; a few studies have investigated the effects of high bilirubin levels on the circulatory system (3,4) . Two in vitro studies performed on the effects of UCH on the myocardial tissue show that UCH damages it, and an in vivo study determines myocardial functional disorder that can be compensated (5,6) . A number of studies determine that bilirubin levels increase the tone of parasympathetic nervous system and cause heart rate variability (7,8) .…”

Section: Introductionmentioning

confidence: 99%

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Effect of Neonatal Hyperbilirubinemia on Ventricular Functions

Karabulut¹,

Şimşek²

2019

ejcm

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Objectives: Unconjugated hyperbilirubinemia is a common systemic disease in neonates. Many studies on etiology, risk factors, and treatment have been conducted, and guidelines have been established. Because unconjugated hyperbilirubinemia is a systemic disease, it affects the body, cells, cellular organelles, organs, and systems. Studies have also attempted to clarify the levels, mechanisms, and organs affected by unconjugated bilirubin. We aimed to investigate the effect of high unconjugated bilirubin levels on the left and right ventricular systolic and diastolic functions in newborns by echocardiography and Doppler. Materials and Methods: This observational retrospectivecohort study evaluated neonates with hyperbilirubinemia requiring treatment according to the American Academy of Pediatrics guidelines, who were Results: There was no correlation between the serum total bilirubin levels and the echocardiographic measures.Conclusions: In our study, unconjugated hyperbilirubinemia did not affect the left and right ventricular functions.

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“…Phototherapy and changes in heart rate Uhríková et al (34) studied the effect of hyperbilirubinaemia and phototherapy on the heart rate and the autonomic nervous system (ANS) by comparing newborns with icterus to…”

Section: Phototherapy and Hemodynamic Changesmentioning

confidence: 99%

Phototherapy and its effect on some physiological functions in newborns

Nandraziova

Matasová

Gumulak

2018

Acta Medica Martiniana

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Phototherapy represents the most common therapeutic intervention at neonatology departments in the first days of life. The beneficial effects of light on the decrease of the serum bilirubin level were first described by Cremer et al. in 1950’s (1). Since then phototherapy has been successfully used to treat severe hyperbilirubinaemia and has almost completely replaced exchange transfusion. Phototherapy is a relatively non-invasive method. However, along with decreasing bilirubin level, it can also influence some other functions: perfusion of organs, predominantly skin; peripheral vascular resistance; distribution of blood flow; heart activity and, thus, also systemic blood pressure along with breathing. A side component of applied light is a certain amount of heat which warms the body surface up and, therefore, the risk of exogenous overheating and increased water loss through the skin arise. Maternal-infant separation, modification of calcium homeostasis, disturbed circadian rhythm, or changes of the hemodynamics of various organ systems are only a few of the undesired effects which prove phototherapy not to be a treatment without any side effects. Careful indication of phototherapy is essential, particularly in premature infants.

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Hyperbilirubinemia and phototherapy in newborns: Effects on cardiac autonomic control

Cited by 19 publications

References 26 publications

Heart rate variability in healthy term newborns is related to delivery mode: a prospective observational study

Heart rate variability in healthy term newborns is related to delivery mode: a prospective observational study

Effect of Neonatal Hyperbilirubinemia on Ventricular Functions

Phototherapy and its effect on some physiological functions in newborns

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